Pauline W. Chen: A Surgeon's Reflections

Medicine in the Age of Twitter

I blog, I tweet, and I use Facebook. I find social media to be an enormously useful tool in my work. But when I mentioned this to a medical colleague of mine, he replied, "I can barely keep up with email. I'm not about to open up that black box."

More than 60% of adults now go online for health-related information, and a majority of those individuals access social media platforms. Nonetheless, there are only a handful of articles in peer-reviewed journals and no evidence-based guidelines for clinicians to use when it comes to social media. For example, should a doctor diagnose or prescribe on Facebook or a blog? Is a doctor liable if she or he misses a patient's tweets about the acute onset of shortness of breath? 

In this week's "Doctor and Patient" column, I explore social media and the patient-doctor relationship. How should doctors and patients use blogs, twitter, and Facebook, if at all? And do they strengthen the therapeutic relationship or detract from it? 

Please leave your comments below or at Tara Parker-Pope's "Well" blog.

Letting the Patient Call the Shots

I would like to believe that the care I give patients is patient-centered. But two weeks ago, Dr. Donald M. Berwick made me wonder if I could do more.

Dr. Berwick, President of the Institute for Healthcare Improvement in Cambridge, Mass., and a leading authority on healthcare quality, published a piece titled, "What 'Patient-Centered' Should Mean: Confessions of an Extremist." In it, he wrote that the U.S. would need radically different systems if we are to provide patients with truly patient-centered healthcare. As Dr. Berwick writes, “[We] would all be far better off if we professsionals recalibrated our work such that we behaved with patients and families not as hosts in the care system, but as guests in their lives.”

In this week's "Doctor and Patient," I interview Dr. Berwick. How do you define "patient-centered care"? Please leave your comments below or on Tara Parker-Pope's "Well" blog.